[Surgical treatment and long-term results of congenital heart disease in adults: early and late follow-up studies in 231 cases].

Abstract

In a past one decade from January 1981 to August 1991, 231 patients over 18 years old with congenital heart disease (CHD) including 65 patients with cyanotic (C) and 166 with acyanotic (AC) diseases, were surgically treated. There were one operative death (0.6 percent mortality) and three late deaths (1.9%) in 166 patients with AC diseases, whereas there were four operative (6.1%), and four late deaths (6.1%) in 65 patients with C. These patients were followed for 3 to 124 months (the mean of 46.4 +/- 11.9) after the operation. Compared with group AC, group C showed a high rate of early postoperative deaths or late deaths. Group AC comprised patients in their forties (95 patients with ASD and 15 with PDA) and those in their thirties (26 with VSD and 13 with ECD) at the operation. On the contrary, except 5 patients with Ebstein disease, a mean age of patients of group C at the operation lay in their twenties. Surgical outcomes for adult patients of group C still pose much problems compared with AC group in terms of decreased heart function, development of collateral circulatory pathway, and impaired hepatic and renal functions by long lasting hypoxemia. In group C decreased heart function or association of abscess of the brain might be the main cause of postoperative LOS. These findings indicate that early diagnosis, recent advanced operative procedure and appropriate postoperative care can provide symptomatic remission for even adult patients with severe CHD with a low mortality.